Addressing the knowledge gap in Palliative Care among the Indigenous workforce: The role of the Program of Experience in Palliative Approach (PEPA) (#587)

Western Australian Centre for Rural Health, University of Western Australia, Perth, WA, Australia

Queensland University of Technology, Queensland

Menzies School of Health Research, Darwin, Northern territory

Background: Indigenous patients with life-limiting conditions have complex needs, experience reduced access to and uptake of treatment, and have lower utilisation of palliative care services than the general population. Lack of understanding of the role of palliative care and poor availability of culturally-safe specialist palliative care services impact on Indigenous people’s end-of-life decision-making.

In 2003
the Australian
Department of Health funded the
Program of Experience in Palliative Approach (PEPA) to enhance
the skills of the generalist health workforce to support people with palliative
care needs. Indigenous
health professionals have been a specific target since 2007. To date, 218 Indigenous
health workers have completed a PEPA placement (8% of overall number of
participants) and 866 participants (7%) have participated in workshops. The
program has been administered and implemented differently in each jurisdiction.

Aim: To
evaluate
the Aboriginal PEPA program for understanding the processes of delivering PEPA
in a culturally-appropriate manner and the impact this has had on end-of-life
care of Aboriginal people.

Methods: A qualitative
approach was taken and involved interviews with jurisdictional Managers,
Aboriginal Project Officers, consultants and Aboriginal PEPA participants.

Results:
Innovative delivery methods and flexible placement options have enhanced participation numbers however participants highlighted some challenges: recruitment, staff retention, stigma around death and dying, funding, content and perceived lack of required support from some local managers. Although findings vary by jurisdiction, connections to an oncology department, the involvement of an Aboriginal mentor during the PEPA placement, and turning PEPA into an accredited course to attract participants were some of the suggestions for program improvement.

Conclusions: Despite
that several issues were identified for further improvement,Indigenous PEPA program provides a
flexible, clinical learning experience that is tailored to meet the needs of Indigenous
health professionals at various levels.